Is neck pain a marker for something serious? Like myelopathy.

Degenerative Cervical Myelopathy (DCM) is a chronic progressive condition of the cervical spine that leads to compression of the spinal cord. It is the most common cause of spinal cord dysfunction in adults, and it occurs due to age-related changes or genetically associated pathologies. DCM is a clinical and radiological diagnosis and presents with a spectrum of symptoms ranging from neck pain and stiffness to paralysis. While neck pain is prevalent amongst patients attending specialist clinics, its predictive value for DCM is limited. This paper focuses on elucidating the relationship between DCM and chronic neck pain, and we discuss the underlying aetiology and broader neurological implications in the context of the literature. The progression of DCM can be slow and insidious with symptoms worsening gradually over time. Neck pain should not be discounted in the evaluation of DCM.

Establishing a comprehensive care paradigm: Insights from a specialised combined scoliosis clinic in Australia.

Orthopaedic spine surgery, particularly for adult spinal deformity, demands extensive expertise due to its complex pathologies. Surgical success hinges on precise planning, multidisciplinary collaboration, and advanced techniques to correct deformities and restore spinal alignment. This study investigates the efficacy of a Combined Monthly Scoliosis Clinic initiated in April 2022 at Spine Service, St George Private Hospital. The clinic integrates adult and paediatric spine surgeons from Sydney, aiming to provide specialized care and educational opportunities. Patient assessments include physical evaluations and tailored imaging, with treatment strategies discussed collaboratively amongst surgeons, fellows, registrars and students. Over an 18-month period, the clinic assessed 41 patients (average age 50.4 years; 61.0 % female) with diverse spinal conditions. Treatment approaches varied, encompassing spinal fusion, decompression, and conservative management tailored to individual pathologies. The Combined Monthly Scoliosis Clinic exemplifies a comprehensive model for managing complex spinal deformities. It emphasizes collaborative diagnostics, personalized treatment planning, and continuous educational enhancement for trainees and fellows. Patient outcomes underscore the clinic's effectiveness in improving quality of life through tailored interventions. This integrated approach sets a benchmark for global spine care centres, ensuring optimal patient-centric care and advancing clinical standards through ongoing feedback and adaptation.

Spinal column radiological factors associated with increased spinal cord intramedullary signal intensity - A study evaluating aging spinal cord's relation to spinal disc degeneration.

PURPOSE: Increased intramedullary signal intensity (IISI) on T2 weighted MRI scan (T2WI) can be a radiological feature of spinal cord degeneration. However, the association of IISI to degeneration of the spinal column that protects the spinal cord remains unclear. The purpose of this study was to determine the prevalence of IISI and analyze the independent relationship between IISI and cervical degenerative parameters on X-ray and magnetic resonance imaging (MRI). METHODS: A retrospective review of MRI, X-ray, and radiology data (n = 144) adult patients with both cervical MRI and X-ray scans was conducted. A total of 39 (27 %) patients with IISI was identified. The remaining 105 patients without IISI made up the control group. RESULTS: IISI was most frequent in C6-C7 cervical levels. The likelihood of having IISI was 1.947 (Exp(B) 1.947, 95 %CI [1.004-3.776]) times higher in segmental levels with facet joint degeneration. There was an increased likelihood of IISI within the spinal cord with increasing age (Exp(B) 1.034, 95 %CI [1.008-1.060]), maximum spinal cord compression (MSCC) (Exp(B) 1.038, 95 %CI [1.003-1.075]), rotational angle (Exp(B) 1.082, 95 %CI [1.020-1.148]) and posterior disc herniation width (Exp(B) 1.333, 95 %CI [1.017-1.747]) and decreasing Torg-Pavlov ratio (Exp(B) 0.010, 95 %CI [0.001-0.068]). CONCLUSION: IISI was independently associated with increased age, facet joint degeneration, MSCC, rotational angle, posterior herniation width and decreasing Torg-Pavlov angle. Radiologicaldegenerative changesassociated with IISI indicates a potential for identifying predictors of age related spinal cord morphological changes in DCM, which may allow for early intervention strategies in the future.